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Objective To investigate the relationship between plasma level of platelet derived growth factor-BB (PDGF-BB), coronary heart disease (CHD) and the severity of coronary artery stenosis. Methods A total of 262 patients hospitalized in Department of Cardiology, Tianjin Chest Hospital were collected in this study. According to the medical history, symptoms, laboratory examination and the results of coronary angiography, patients were divided into stable angina pectoris (SAP) group (n=57), acute coronary syndrome (ACS) group (n=119) and normal control group (n=86). The ACS group was divided into three subgroups:single vessel group (n=38), double vessel group (n=35) and multiple vessel group (n=46). The general clinical data, biochemical parameters and plasma PDGF-BB levels were compared between SAP group, ACS group and control group. Spearman correlation analysis was used to analyze the relationship between PDGF-BB level, high-sensitivity C-reactive protein (hs-CRP) and Gensini scores. Logistic regression analysis was used to analyze the risk factors of coronary heart disease. Results (1) The plasma levels of hs-CRP and PDGF-BB were significantly higher in ACS group than those in control group and SAP group (P0.05). (3) There was no significant difference in plasma level of PDGF-BB between single vessel group, double vessel group and multiple vessel group (P > 0.05). (4) Logistic regression analysis showed that high plasma level of PDGF-BB was the risk factor for coronary heart disease. Conclusion PDGF-BB plasma level is associated with the pathogenesis of coronary heart disease, which may reflect the instability of coronary atherosclerotic plaques, but it is not an index to evaluate the severity of coronary stenosis.
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Objective: To observe the automatic ventricular capture management (VCM) conifrmed by paced depolarization integral (PDI) evoked response detection via the follow-up study in patients with Zephyr5826 pacemaker implantation. Methods: A total of 102 relevant patients were enrolled. In order to conduct PDI calculation, pacemakers were set by bipolar sensing and bipolar pacing at immediately after implantation. VCM functions were observed at 1 day, 7 days and 1 month, 3, 6, 12 months after implantation, the ventricular threshold by VCM test and manual test were compared. The symptoms of pectoralis major stimulus, diaphragm stimulus and palpitation were observed in all follow-up patients. Results: There was 1 patient died by MI at 1 month after Zephyr5826 pacemaker implantation, the rest 101 patients were followed-up for 12 months. VCM function was successfully turned-on at immediately after implantation in all patients, no pectoralis major stimulus and diaphragm stimulus occurred. VCM function was turned-off in 6/101 (5.9%) patients at 7 days after implantation due to intolerable palpitation caused by daily automatic VCM, instead they received manual test at follow-up visit. The coincidence rate of ventricular thresholds between VCM test and manual test were 100%. Ventricular pacing output voltage by VCM was (0.99 ± 0.48) V,n=608. Compared with regular pacing output voltage (2.5V, 0.4ms), VCM function may save 84% of energy consumption; compared to high pacing output voltage (3.5V, 0.4ms), VCM may save 92%. Loss of ventricular capture and poor sensation were not found by ECG and 24 h dynamic monitoring. Conclusion: Zephyr5826 pacemaker may conduct bipolar pacing and scanning with VCM function, it can be effectively and safely operated by low energy output. A few patients may not use VCM function due to intolerable palpitation.
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Objective To investigate the predictive value of the non-invasive indicator deceleration capacity of heart rate (DC) in the sudden cardiac death (SCD) after acute myocardial infarction. Methods A total of 417 myocardial infarc?tion patients with ST-segment elevation in sinus rhythm were enrolled in this study. DC was assessed from data of 24-hour ECG Holter. Regular follow-ups were carried out within 12 months. The SCD events were recorded and compared with pa?tients without SCD. Results During 12 months of follow-up, 20 patients were died due to SCD (4.8%). Compared with sur?vival group, patients showed significantly lower left ventricular ejection fraction (LVEF, 0.393 ± 0.065 vs 0.528 ± 0.042, P<0.05) and DC [(2.85±1.66) ms vs (5.49±1.71) ms,P<0.05]in SCD group. Multivariate Cox proportional hazard regression analysis showed that lower LVEF(<0.35)[RR: 2.167(1.384-4.661), P=0.013]and DC (DC<4.5 ms)[RR: 3.706(2.709-5.374),P=0.020]were risk factors for the occurrence of SCD. The prediction sensitivity by the decreased LVEF and DC was 52.1%and 76.4%respectively, and the specificity was 84.5%and 86.1%respectively. Conclusion The decreased value of DC after acute myocardial infarction can predict the SCD events.
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Objective To investigate the effect and mechanism of Imatinib mesilate (Imatinib) on intimal hyperplasia of rabbit carotid arteries after balloon injury. Methods Thirty adult Newzealand rabbits were randomly divided into three groups:group A, B and C. Their right carotid arteries were injuried then administered with 0, 25 or 50 mg/kg of Imatinib dai?ly for 14 consecutive days when the rabbits were sacrificed. The carotid arteries were harvested and sectioned for HE-stain?ing and immunohistochemisty staining. Real-Time PCR was used to examine transcription levels of PDGF-B and PDGFR-βmRNA. The plasma level of PDGF-BB was assayed by ELISA. Results Arterial intimal hyperplasia and stenosis following balloon injury were seen in three groups. Thickness and area of neointima, ratio of thickness of intima to media, ratio of area of intima to media and mRNA level of PDGF-β are all higher in group A than those in group B than those in group C (P<0.01). By contrast, the mRNA transcription level of PDGFR-β increased significantly in group C than that in group A (1.236±0.356 vs 0.708±0.372;t=2.91;P<0.01). Plasma level of PDGF-BB increased in all three groups after balloon injury than that in the baseline (P<0.01). The transcription level of PDGF-BB is higher in group A than that in group B and in group C (ng/L:23.464±3.542, 19.504±2.454, 16.588±1.207, F=17.322, P<0.05). There was no difference between group B and C. There was positive correlation between mRNA transcription level of PDGF-B and plasma level of PDGF-BB ( r=0.806, P<0.01). Conclusion Vascular injury can cause intimal hyperplasia and increased PDGF-B mRNA transcription. Imatinib mesilate could inhibit the intimal hyperplasia through down regulating PDGF-B mRNA transcription.
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Objective To investigate the association of platelet-derived growth factor(PDGF)-B gene single nucleotide polymorphism(SNP) and plasma PDGF-BB level with in-stent restenosis(ISR) in elderly patients.Methods 157 patients who had undergone coronary artery stenting for more than half year were divided into ISR group(n=74) and NISR group(non-ISR,n=83) according to the angiographic diagnosis of in-stent restenosis (ISR).Plasma level of PDGF-BB was measured by enzyme-linked immunosorbent assay(ELISA).DNA was isolated from leukocytes.Two SNPs of the PDGF-B gene(rs1800818 and rs1800817) were determined by Taqman Quantitative Real-Time PCR with TaqMan-MGB probe.Results There were no significant differences in genotype frequency of rs1800818 AA,AG,GG between ISR group and NISR group(x2 =4.48,P＞0.05).The frequency of rs1800818A allele was much higher in ISR group than in NISR group(x2 =5.33,P＜0.05).There were no significant differences in genotype frequency of SNP rs1800817 AA and AC(x2 =0.06,P＞ 0.05) and allele frequency of SNP rs1800817 A and C(x2 =0.06,P＞0.05) between ISR group and NISR group,while genotype CC was not found.The plasma level of PDGF-BB was higher in ISR group than in NISR group [(6.53±3.65) ng/L vs.(5.07±2.45) ng/L,t=2.92,P＜0.01].Plasma level of PDGF-BB in patients with rs1800818 AA genotype was significantly higher in ISR group than in NISR group [(9.94 ± 4.60) ng/L vs.(5.90 ± 2.98) ng/L,t =2.69,P＜0.05].Multivariable logistic regression analysis showed that plasma PDGF-BB level was the risk factor for ISR (OR =1.187,95.0％ CI:1.054 1.337,P＜0.01).Conclusions High plasma PDGF-BB level is the risk factor for ISR,but PDGF-B gene SNPs rs1800818 and rs1800817 are not associated with the occurrence of ISR.